ObjectiveTo sum up experiences of precaution and provide evidence to prevent such accidents in the future via analyzing the nosocomial infection in newborn babies who were infected by rotavirus. MethodsWe investigated and monitored the 8 cases of nosocomial infection occurred between July 7th and July 14th, 2012 by epidemiologic and environmental hygienic methods, and analyzed the existing risk factors and took measures to control. ResultsThere were 8 nosocomial infected cases among the 45 newborn babies who were hospitalized. The infection rate was 17.8% and the accident lasted for 7 days. The distribution of space, time and population was clustered. Environment and hands were the main media to spread the virus. ConclusionThe accident was a suspected nosocomial infection caused by rotavirus in the hospital. It can be controlled effectively through intensive cleaning and sterilizing, isolated touching, and improving the medical staff's compliance and accuracy rate of hand sanitation.
Objective To study the clinical feasibility of invasive mechanical ventilation with bilevel positive airway pressure（BiPAP） non-invasive ventilator in the stable patients needing prolonged mechanical ventilation.Methods Eleven patients with respiratory failure admitted in intensive care unit（ICU）of our department，who needed prolonged mechanical ventilation，between Jun 2004 and Nov 2007 were enrolled in the study and followed until death or Jan 2008.The arterial blood gas analysis data，length of stay(LOS)，LOS after changing to BiPAP non-invasive ventilator（Synchrony，Harmony，RESPIRONICS，VPAP III ST-A，RESMED），survival time after discharge(or fulfilled the discharge standards) were reviewed retrospectively.Results The settings of inspiratory pressure，expiratory pressure and respiratory rate of non-invasive ventilation were 21.3 (16-26) cm H2O，4 cm H2O，and 16 min-1，respectively.The LOS (or up to the discharge standard) was (91.5±50.2) days.The LOS (or up to the discharge standard) after changing to BiPAP ventilator was (23.5±12.2) days.The mean survival time after discharge (or up to the discharge standard) was (353.1±296.5) days.Four patients were still alive up to the end of the study.The arterial pH，PaCO2，PaO2，and SaO2 were not significant different before and after changing to BiPAP ventilator.Conclusion The mechanical ventilation with BiPAP non-invasive ventilator via tracheotomy tube is an alternative choice for stable patients needing prolonged mechanical ventilation.
ObjectiveTo analyze hospitalized patients of respiratory diseases with mechanical ventilation (MV). MethodsHospitalized patients with or without MV were enrolled into the current study from January 2010 to December 2014. Patients' characteristics including age and sex, type of illness and costs of hospital treatment were retrospectively analyzed. ResultsA total of 9,539 patients were hospitalized into Department of Respiratory Medicine, The General Hospital of Shenyang Military Area Command in the past 5 years. Of them, 1,531 (16.0%) patients were treated with MV, 764 of the 1,531 (49.9%) patients received non-invasive mechanical ventilation (NIMV), 135 of the 1,531 (8.8%) received invasive mechanical ventilation (IMV), and 632 of the 1,531 (41.3%) received NIMV plus IMV. The percentage of patients older than 65 years in the three groups as above were 71.3%, 63.0% and 72.2%, significantly higher than the Non-MV group's 47.7% (P<0.05); the percentage of males were 52.7%, 82.2% and 63.3% respectively, the later two groups was significantly higher than the Non-MV group's 59.2% (P<0.05); the percentage of ICU admission were 67.0%, 70.4% and 82.8%, significantly higher than the Non-MV group's 24.0% (P<0.05); the percentage of type Ⅰ respiratory failure were 12.4%, 29.6% and 12.4%, the later two groups was significantly higher than the Non-MV group's 13.2% (P<0.05); the percentage of type Ⅱ respiratory failure were 76.6%, 17.8% and 47.0%, all were significantly higher than the Non-MV group's 7.6% (P<0.05). Twenty-one kinds of common co-morbidities for respiratory hospitalized patients were analyzed and it was found that MV patients were likely to have more co-morbidities. Compared to Non-MV group, IMV group had more co-morbidities of type Ⅰ or type Ⅱ respiratory failure caused by pneumonia, bronchiectasis and other infectious diseases and concomitant with hypoalbuminemia, gastrointestinal bleeding and liver and kidney dysfunction and cerebrovascular disease, with statistically significant differences (P<0.05); NIMV group had more co-morbidities of type Ⅱ respiratory failure caused by chronic bronchitis, emphysema, pulmonary heart disease and other chronic airway diseases, and concomitant with coronary heart disease, heart failure, cerebrovascular disease and renal dysfunction, with statistically significant differences (P<0.05); the co-morbidity spectrum of NIMV plus IMV group was between those of IMV and NIMV groups, but more similar to that of IMV group. The high risk factors for IMV were pneumonia, hypoalbuminemia, gastrointestinal bleeding, and cerebrovascular disease; for NIMV were chronic bronchitis, emphysema, pulmonary heart disease, type Ⅱ respiratory failure and cardiac dysfunction. Cost analysis showed that average cost of Non-MV, NIMV, IMV, and NIMV plus IMV patients were 16 359 yuan, 31 872 yuan, 66 924 yuan, and 98 648 yuan respectively, in which the expense of NIMV plus IMV patients was vastest. ConclusionsHospitalized patients receiving MV therapy tend to be older, stay in ICU, complicated with respiratory failure and multiple co-morbidities. Respiratory failure by chronic obstructive airways disease is more often treated with NIMV, but respiratory failure by lung infection often need IMV.
目的研究p16基因甲基化在乳腺癌中的分布情况，并探讨其与乳腺癌发生、发展的关系。方法采用甲基化特异的PCR技术检测四川省肿瘤医院乳腺科2008年3～9月期间收治的38例原发性乳腺癌组织及距离肿瘤＞5 cm以远的正常乳腺组织中p16基因启动子区CpG岛甲基化频率。结果乳腺癌组织中p16基因启动子区CpG岛甲基化频率〔31.6%（12/38）〕明显高于其正常乳腺组织〔5.3%（2/38）〕，差异有统计学意义（P=0.003）。有淋巴结转移的乳腺癌患者中p16基因甲基化频率〔45.5%（10/22）〕高于无淋巴结转移患者〔12.5%（2/16）〕，差异有统计学意义（P=0.044）。结论p16基因启动子区CpG岛甲基化可能在乳腺癌发生、发展过程中起着重要作用。
Objective To report the anti-epidemic work for counterpart-supporting Longmen township, the epicenter of Lushan earthquake, by Mianyang health and epidemic prevention team from the first day to one month after the earthquake. Methods a) The following information was collected: work information and report forms of each counterpart-support small group, government work information, work information statistics and historical epidemic materials of health center, and epidemic prevention materials of Beichuan county. b) The epidemic prevention work of Longmen township from the first day to one month after earthquake were documentarily described, the expert group review was adopted to assess the disaster situation, epidemic situation and health needs, and the visual observation and trace method were used to monitor the vectors. Results a) The first team arrived in Ya’an city at the 19th hour after earthquake. The members of the team put forward the “City in-charge-of Township counterpart-support anti-epidemic mode” and they were approved to counterpart-support Longmen township. b) The second team involving 48 members assigned to the first team within 5 days after earthquake. Totally 224 local people were called up and they carried out a comprehensive work based on the “City in-charge-of Township counterpart-support anti-epidemic mode”: water quality and disease surveillance, disinfection and disinsectization at key sites, epidemic prevention in settlements, large-scale health education, and psychological intervention. c) As of 1 month after the earthquake, Mianyang health and epidemic prevention team had dispatched 20 vehicles and 122 people participated in the post-disaster epidemic prevention in Longmen township. The total disinfection area was 1 725 400 square meters, and disinsectization area was 1 162 500 square meters; 184 water samples were collected, and 7 717 family-times’ drinking water disinfection were guided; nearly 28 000 publicity materials were distributed; 8 636 people were visited and received for diagnosis; 33 cases with watery diarrhea and 16 cases with fever were found; 117 people were trained about mental health service, 3 mental health service stations were set up, and 1 152 people were helped with special population mental health services. Conclusion a) Mianyang health and epidemic prevention team combined the special requirements of epidemic prevention in Lushan earthquake with the proficient experiences and work modes of epidemic prevention in Mianyang as the extremely-severe stricken area in Wenchuan earthquake, and put forward the “City in-charge-of Township counterpart-support mode” which is implemented and verified in the anti-epidemic practice in epicenter of Longmen Township. b) Compared with the epidemic prevention in Qushan township of Beichuan county which is the epicenter of both Lushan and Wenchuan earthquakes: the following 8 aspects (including the “City in-charge-of Township counterpart-support” formed, the first anti-epidemic team entered into the village, full coverage of anti-epidemic team entered into the village, direct reporting network recovered, settlement’s regular administration started, water supply guaranteed, drinking water monitoring initiated, emergency vaccination initiated) were performed earlier in Lushan than Wenchuan, with 42 days, 2 days, 32 days, 4 days, 10 days, 6 days, 7 days, and 19 days in advance, respectively. c) The overall performance is faster, more reasonable, and more efficient. It can provide first-hand information for globally similar earthquake’s epidemic prevention, and also the decision-making and reference for both post-disaster reconstruction and construction of regional state disaster emergency response system.
ObjectiveTo survey the current asthma impact on quality of life and related factors in China. MethodsTwo thousand and thirty-four asthmatic patients, from bronchial asthma prevalence epidemiology survey in the population over 14 years old in 8 areas of China from 2009 to 2013, were enrolled. The data about medical resource use, control status and quality of life were collected by detailed questionnaire and analysed using the Epidata database and SAS 9.2 software. ResultsOut of the 2034 asthma patients, 1213 patients (59.6%) reported that their activities including entertainment, learning, fertility and employment were limited due to asthma. In the four aspects of entertainment, education, family and employment, 688 patients (33.8%) had one limited activity in one aspect, 165 patients (8.19%) had most of activities limited in one aspect, 246 patients (12.1%) had limited activities in two or three aspects, 114 patients (5.6%) had limited activities in all aspects. One hundred and eighty-one patients (8.9%) needed help in daily life, such as cooking, shopping, doing housework. Seventy-one patients (3.5%) even needed help in eating, personal hygiene, toilet, and their daily activities were remarkably restricted. Eighty-one patients (4.0%) had motive of suicide. Aging, comorbidity, and medication use were the most important factors. ConclusionAsthma has a significant negative effects on the life and emotion of patients, and proper control of comorbidity and regular treatment of asthma are effective ways to improve the life and emotional state of patients with asthma.